Early outcomes of patient-specific posterior stabilized total knee arthroplasty implants.

Patient-specific implants have been linked to stiffness. The purpose of this study was to evaluate outcomes in patient-specific implants. We performed a retrospective review with a primary outcome of manipulation under anesthesia (MUA); secondary outcomes included Knee Society Scores (KSS), Knee Society Functional Scores (KSFS), range of motion (ROM), and Forgotten Joint Scores (FJS). Pre-operative measurements were similar in both groups. There was one MUA in the CPS and two in the OTS groups. There was no difference in postoperative scores. Our study suggests patient-specific implants have comparable rates of MUA and functional outcomes as conventional implants.

Hydraulic distension of the knee: a novel treatment for arthrofibrosis after total knee replacement (case series).

BACKGROUND: Arthrofibrosis following total knee arthroplasty (TKA) is a common problem, which can be frustrating to both the patient and treating physician and can dramatically compromise post-operative function. Current treatment options for TKA arthrofibrosis include watchful waiting, injections, physical therapy, manipulation under anaesthesia, arthroscopic/open lysis of adhesions and revision surgery. We present a novel technique to treat acute and chronic stiffness following TKA, which we call hydraulic distension. METHODS: A retrospective pre- and post-operative inpatient and outpatient record review of three patients treated with hydraulic distension for arthrofibrosis following TKA at a single institution. RESULTS: Three patients with a mean age of 74 years (68-78) underwent hydraulic distension of the knee at a mean of 23.4 ± 18.4 months (9 weeks to 36 months) following primary TKA. The mean pre-distension maximum flexion was 86.7 ± 10.4°, and the mean post-distension flexion was 110 ± 13.2° (23.3° increase). The patients maintained a mean 110 ± 20° flexion (23.3° increase) at a mean follow-up of 11.7 months (1 week to 29 months). There were no complications. CONCLUSION: We present a novel technique for managing arthrofibrosis following TKA that has not been previously reported. This is an effective, safe procedure, with our patients experiencing a mean 23° increased knee flexion at the most recent follow-up.

The medial entorhinal cortex is necessary for temporal organization of hippocampal neuronal activity.

The superficial layers of the medial entorhinal cortex (MEC) are a major input to the hippocampus. The high proportion of spatially modulated cells, including grid cells and border cells, in these layers suggests that MEC inputs are critical for the representation of space in the hippocampus. However, selective manipulations of the MEC do not completely abolish hippocampal spatial firing. To determine whether other hippocampal firing characteristics depend more critically on MEC inputs, we recorded from hippocampal CA1 cells in rats with MEC lesions. Theta phase precession was substantially disrupted, even during periods of stable spatial firing. Our findings indicate that MEC inputs to the hippocampus are required for the temporal organization of hippocampal firing patterns and suggest that cognitive functions that depend on precise neuronal sequences in the hippocampal theta cycle are particularly dependent on the MEC.